Medicaid recipients can get prescription filled even if unable to pay co-payment fee

By Graham Bowman, Equal Justice Works youth health attorney

I recently assisted a homeless youth who was illegally denied a prescribed asthma inhaler because she was unable to pay a co-payment fee.

Have you ever faced a situation like Dana’s?

Dana, 23, lives in a large homeless shelter in Chicago. She must leave the facility by 7:30 every morning, carrying all her things in backpacks and duffle bags. Dana often heads over to a homeless youth drop-in center, where she can spend part of the day and get any needed assistance. But Dana suffers from asthma, making the long walks tiresome and sometimes threatening to her health.

Dana has Medicaid to cover her health care, including an inhaler and other prescriptions. When she tried to fill her prescriptions on a recent morning, she was refused because she was unable to pay $7.90 in copayment fees. Going without her medicine worsened her asthma, causing her great difficulty in breathing while walking to the drop-in center.

Dana asked me for assistance, and I contacted the pharmacy to explain that by law, she should not have been turned away. 

In Illinois, Medicaid charges copay fees of $2 to $4 to fill most prescriptions. These amounts seem nominal, but are unaffordable for people who are unemployed and unstably housed. They  need to save what little money they have for food and bus passes.

State and federal laws require pharmacies to distribute medication to Medicaid recipients who are unable to pay their copay. Despite this protection, many pharmacies routinely deny homeless youth important medications if they cannot pay their copayment.

The Law Project has written a form letter that individuals unable to pay a co-payment fee can give to a pharmacy. The letter explains to a pharmacy that the individual cannot pay the copayment at this time but would still like their medication distributed to them.

Pharmacies and individuals may contact the Law Project for more information or assistance. Call the Law Project at its toll-free line, (800) 940-1119, or email